Healthcare Provider Details

I. General information

NPI: 1215672910
Provider Name (Legal Business Name): TRANSCEND EMDR AND SOMATIC THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2022
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5102A OAK PARK RD
RALEIGH NC
27612-3027
US

IV. Provider business mailing address

5102A OAK PARK RD
RALEIGH NC
27612-3027
US

V. Phone/Fax

Practice location:
  • Phone: 910-372-5008
  • Fax:
Mailing address:
  • Phone: 910-372-5008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHRISTOPHER L. DILLON
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 910-372-5008